CCM EXAM NEWEST 2026/2027 ACTUAL EXAM TEST BANK |
COMPLETE PRACTICE QUESTIONS WITH VERIFIED ANSWERS |
GRADED A+ PDF
Which evaluation would you perform to determine if a client has the capability to return to work?
a. pain tolerance evaluation
b. functional capacity evaluation
c. disability evaluation
d. evaluation by client interview - ANSWER B.
The functional capacity exam is a process of assessing a person's physical and functional abilities to
perform tasks. The patient's performance level should match the demands of the occupation in
question. The purpose of the exam is to determine if a patient is ready to go back to work after an
injury.
Risk management is a subdomain of which one of the following core case management domains?
a. psychosocial aspects
b. healthcare management and delivery
c. principles of practice
d. case management concepts - ANSWER C.
There are six domains for case management practice. These include:
-case management concepts
-case management principles and practice strategies/practice
-psychosocial and support systems
-healthcare management and delivery
-healthcare reimbursement
-vocational concepts/strategies
Risk Management is a subdomain of case management principles and practice/strategies.
The case management process of documenting goals, objectives, and actions to meet a clients needs
is called:
,a. assessment
b.coordination
c. planning
d. monitoring - ANSWER C.
Planning is the process by which a case manager documents goals, objectives, and actions that will
meet a client's needs. Assessment entails gathering data about a client's special needs and situation
prior to forming a case management plan. Coordination involves organization, modification, and
documentation of resources necessary to achieve goals set forth in the plan, and monitoring involves
securing information needed to gauge the effectiveness of the plan.
Which of the following is a major component of essential knowledge for a case manager?
a. healthcare reimbursement
b. moral character
c. independent practice principles
d. statistical analysis - ANSWER A.
Healthcare reimbursement is one of the major categories of knowledge necessary for a case
manager, because there are many different reimbursement mechanism available depending upon
the patient's particular situation.
The PRIMARY role of the case manager is to act as a:
a. patient advocate
b. disease manager
c. utilization reviewer
d. care plan creator - ANSWER A.
Patient advocate is best ANSWER Advocacy is essential to a case manager's daily practice. A case
manager acts on behalf of clients who may not be able to speak for themselves or who are not
knowledgeable about health care. Above all, the case manager should always have the client's best
interest in mind.
Which model of healthcare decision making best demonstrates the principle of beneficence?
a. patient sovereignty
,b. paternalism
c. shared decision making
d. maternalism - ANSWER B. Paternalism
A relationship between healthcare practitioners and patients is paternalistic and beneficent. This
means that people truest the practitioner to do what is in the best medical interest of the patient.
Paternalism is justified in that patients usually don't comprehend medical concepts well enough to
make the correct decision about their care. in the patient sovereignty model, the patient is "boss". In
this case, one could argue that the patient knows better than anyone else what is in his best
interests. Shared decision making means the healthcare team and the patient work together.
According to the Standards of Practice for Case Managers, there are four key functions of case
manager. Which of the following is NOT one of the key functions?
a. planner
b. assessor
c. litigator
d. advocate - ANSWER C.
The four key functions of a case manager are planer, assessor, facilitator, and advocate.
A case manager must assess a situation to identify problems that need case management. The case
manager must also plan long- and short-term goals in collaboration with the client, the client's
family, and with other healthcare professionals. Facilitation includes coordinating and implementing
the care plan, maintaining communication, and expediting care. As an advocate, the case manager
ensure that the client's needs are identified and addressed.
Nursing case management that is "within the walls" refers to which setting?
a. outpatient setting
b. community clinic setting
c. health maintenance organization (HMO)
d. acute hospital setting - ANSWER D.
The term "within the walls" (WTW) refers to activities with the acute hospital environment. This is
distinct from "beyond the walls" (BTW), which refers to case management in outpatient and
community settings.
A terminally ill client is exhausting all financial resources to pay medical costs. The case managers has
suggested obtaining cash value on his life insurance policy prior to death. This process is know as a:
, a. nontraditional policy
b. supplementary policy
c. viatical settlment
d. gatekeeping - ANSWER C.
This scenario describes the process known as a viatical settlement whereby a patient can obtain cash
value from a life insurance policy prior to death. ANSWERs A, B, and D are irrelevant to the situation.
A relationship whereby a case manager acts in a clients best interest based on trust is know as:
a. fiduciary
b. ex parte
c. tort
d. due diligence - ANSWER A.
A case manager establishes a relationship with a client to advocate for his best interests. This makes
the case manager a fiduciary. The term ex parte refers to a legal proceeding or a legal order. A tort,
on the other hand, refers to a wrongful act performed willfully. When a person investigates a
business or personal relationship prior to signing a contract, he is performing due diligence.
When a case manager refers a client to a specific provider, what type of relationship exists between
the case manager and the provider?
a. vicarious agency
b. advocate
c. ostensible agency
d. favoritism - ANSWER C.
The relationship that exists between the case manager and a referral provider is an ostensible
agency. If that provider were to perform negligent actions, the referring case manager may also
become subject to litigation. A fiduciary is a relationship whereby the case manager acts in the
client's best interests. The case manager is an advocate for the client, not the provider.
A case manager knowingly refers a patient to a provider who is unqualified to render services to the
patient. This is known as a:
COMPLETE PRACTICE QUESTIONS WITH VERIFIED ANSWERS |
GRADED A+ PDF
Which evaluation would you perform to determine if a client has the capability to return to work?
a. pain tolerance evaluation
b. functional capacity evaluation
c. disability evaluation
d. evaluation by client interview - ANSWER B.
The functional capacity exam is a process of assessing a person's physical and functional abilities to
perform tasks. The patient's performance level should match the demands of the occupation in
question. The purpose of the exam is to determine if a patient is ready to go back to work after an
injury.
Risk management is a subdomain of which one of the following core case management domains?
a. psychosocial aspects
b. healthcare management and delivery
c. principles of practice
d. case management concepts - ANSWER C.
There are six domains for case management practice. These include:
-case management concepts
-case management principles and practice strategies/practice
-psychosocial and support systems
-healthcare management and delivery
-healthcare reimbursement
-vocational concepts/strategies
Risk Management is a subdomain of case management principles and practice/strategies.
The case management process of documenting goals, objectives, and actions to meet a clients needs
is called:
,a. assessment
b.coordination
c. planning
d. monitoring - ANSWER C.
Planning is the process by which a case manager documents goals, objectives, and actions that will
meet a client's needs. Assessment entails gathering data about a client's special needs and situation
prior to forming a case management plan. Coordination involves organization, modification, and
documentation of resources necessary to achieve goals set forth in the plan, and monitoring involves
securing information needed to gauge the effectiveness of the plan.
Which of the following is a major component of essential knowledge for a case manager?
a. healthcare reimbursement
b. moral character
c. independent practice principles
d. statistical analysis - ANSWER A.
Healthcare reimbursement is one of the major categories of knowledge necessary for a case
manager, because there are many different reimbursement mechanism available depending upon
the patient's particular situation.
The PRIMARY role of the case manager is to act as a:
a. patient advocate
b. disease manager
c. utilization reviewer
d. care plan creator - ANSWER A.
Patient advocate is best ANSWER Advocacy is essential to a case manager's daily practice. A case
manager acts on behalf of clients who may not be able to speak for themselves or who are not
knowledgeable about health care. Above all, the case manager should always have the client's best
interest in mind.
Which model of healthcare decision making best demonstrates the principle of beneficence?
a. patient sovereignty
,b. paternalism
c. shared decision making
d. maternalism - ANSWER B. Paternalism
A relationship between healthcare practitioners and patients is paternalistic and beneficent. This
means that people truest the practitioner to do what is in the best medical interest of the patient.
Paternalism is justified in that patients usually don't comprehend medical concepts well enough to
make the correct decision about their care. in the patient sovereignty model, the patient is "boss". In
this case, one could argue that the patient knows better than anyone else what is in his best
interests. Shared decision making means the healthcare team and the patient work together.
According to the Standards of Practice for Case Managers, there are four key functions of case
manager. Which of the following is NOT one of the key functions?
a. planner
b. assessor
c. litigator
d. advocate - ANSWER C.
The four key functions of a case manager are planer, assessor, facilitator, and advocate.
A case manager must assess a situation to identify problems that need case management. The case
manager must also plan long- and short-term goals in collaboration with the client, the client's
family, and with other healthcare professionals. Facilitation includes coordinating and implementing
the care plan, maintaining communication, and expediting care. As an advocate, the case manager
ensure that the client's needs are identified and addressed.
Nursing case management that is "within the walls" refers to which setting?
a. outpatient setting
b. community clinic setting
c. health maintenance organization (HMO)
d. acute hospital setting - ANSWER D.
The term "within the walls" (WTW) refers to activities with the acute hospital environment. This is
distinct from "beyond the walls" (BTW), which refers to case management in outpatient and
community settings.
A terminally ill client is exhausting all financial resources to pay medical costs. The case managers has
suggested obtaining cash value on his life insurance policy prior to death. This process is know as a:
, a. nontraditional policy
b. supplementary policy
c. viatical settlment
d. gatekeeping - ANSWER C.
This scenario describes the process known as a viatical settlement whereby a patient can obtain cash
value from a life insurance policy prior to death. ANSWERs A, B, and D are irrelevant to the situation.
A relationship whereby a case manager acts in a clients best interest based on trust is know as:
a. fiduciary
b. ex parte
c. tort
d. due diligence - ANSWER A.
A case manager establishes a relationship with a client to advocate for his best interests. This makes
the case manager a fiduciary. The term ex parte refers to a legal proceeding or a legal order. A tort,
on the other hand, refers to a wrongful act performed willfully. When a person investigates a
business or personal relationship prior to signing a contract, he is performing due diligence.
When a case manager refers a client to a specific provider, what type of relationship exists between
the case manager and the provider?
a. vicarious agency
b. advocate
c. ostensible agency
d. favoritism - ANSWER C.
The relationship that exists between the case manager and a referral provider is an ostensible
agency. If that provider were to perform negligent actions, the referring case manager may also
become subject to litigation. A fiduciary is a relationship whereby the case manager acts in the
client's best interests. The case manager is an advocate for the client, not the provider.
A case manager knowingly refers a patient to a provider who is unqualified to render services to the
patient. This is known as a:
